STOMACH ACID FOOD FOR THOUGHT

[Guest guest]

I have not verified the accuracy of this information, but it is interesting. I am going to discuss it with my surgeon Thursday.

"Killing off (stomach) acid, however it's done, is a serious mistake

with long term consequences if pursued over time. Poor digestion

is the genesis of all sorts of problems."

That quote from HSI Panelist Allan Spreen, M.D. appeared in

the e-Alert "Fire Down Below" (12/23/02). And I immediately

recalled Dr. Spreen's words when I came across an astonishing

study last week that demonstrates how several popular heartburn

medications may sharply increase the risk of pneumonia.

------------------------------------------------------------

The tradeoff

------------------------------------------------------------

The new study appears in an October issue of the Journal of the

American Medical Association, and was conducted by researchers

at a university medical center in the Netherlands. The Dutch team

evaluated data collected from the medical records of more than

360,000 patients enrolled in a primary care database. Each subject

had been enrolled for a minimum of one year.

The researchers concluded that the use of drugs to suppress gastric

acid quadrupled the risk of pneumonia compared to patients who

didn't use the drugs. That's right: Four TIMES the risk!

The drugs analyzed in this study were from two different classes:

proton pump inhibitors (for acid reflux) and H2 receptor

antagonists (for heartburn). Here are the familiar brand names in

these two classes:

Proton pump inhibitors: Nexium, Prilosec, Prevacid, Protonix,

Aciphex

H2 receptor antagonists: Pepcid, Zantac, Tagamet, Rotane, Axid

And to make matters worse, some patients are not even taking

these drugs to address heartburn or acid reflux. As one doctor told

WebMD, many physicians who prescribe nonsteroidal anti-

inflammatory drugs (NSAIDs) to address arthritis pain, also

prescribe acid-suppressing drugs to offset the risk of ulcers.

The justification for using these drugs is based on the completely

wrongheaded belief that stomach acid is bad. Which overlooks the

obvious: Stomach acid is there for a reason. You can't digest food

without it! No wonder Dr. Spreen calls acid suppression "a serious

mistake with long term consequences."

------------------------------------------------------------

Acids rising

------------------------------------------------------------

So, how might an acid-suppressing drug increase the risk of

pneumonia? The Dutch study doesn't answer that question, which

opens the door to some interesting speculation.

In the WebMD article about the study, Peura, M.D., who is

a spokesman for the American Gastroenterological Association,

observed that untreated acid reflux is known to increase the risk of

pneumonia. Noting that subjects in the study who received the

highest doses of acid-suppressants had the highest risk of

pneumonia, Dr. Peura asked this hypothetical question: What

caused the pneumonia; the acid reflux, or the drug to treat acid

reflux?

When I asked Dr. Spreen for his insights on this matter, he

suggested that the drug itself doesn't cause pneumonia, but rather

sets the stage for stomach acid to create problems. But if the drug

suppresses acid, how can acid be the cause of the pneumonia risk?

Dr. Spreen explains:

"When acid is reduced (which makes you feel better for awhile), it

also loosens the gastroesophageal (GE) sphincter, the 'door' that's

supposed to close between the stomach and the esophagus when

digestion is going on (or trying to, anyway). The body is trying to

insulate the esophagus from the acid. But if there's no longer much

acid, why waste all that energy and effort?

"So, the sphincter loosens, permitting what little acid remains to

slip up into the esophagus. This is where the 'heartburn' and

esophageal damage (Barrett's esophagus) come from, and the

subsequent need for more 'anti-acid' therapy. See where this is

headed over the long run?

"If the acid migrates far enough (and I believe it does in these

cases), it reaches the junction where the lungs branch off, and

there's the rub. Even the tiniest amount of acid is highly irritating

to such membranes, and subsequently a source for trouble to start,

including infection."

------------------------------------------------------------

Between a rock and a hard place

------------------------------------------------------------

It's obvious from the popularity of acid-suppressing drugs that

there are plenty of people who suffer from occasional heartburn or

chronic acid reflux. Leaving the production of excess acid

unchecked is not only painful, but also dangerous. But suppressing

the acid can create dangerous problems as well, and pneumonia

risk is just one of them.

In an e-Alert I'll send you next week, I'll review Dr. Spreen's

simple, inexpensive and effective way to treat gastroesophageal

problems without suppressing acids.

**************************************************************

[Guest guest]

I'm surprised there are no other comments on this. This really got me

thinking about causes for achalasia, and possible treatment. I've long

wondered if acid reflux or over production of acid was a cause of

achalaisa, somewhat like the other condition of a stricture higher in

the esophegus from acid reflux. At any rate, the comment about acid

production causing tension in the LES (sounds like achalasia to me) &

lowering stomach acid relaxing it... I wonder if anyone has done a

serious study on the effect of ant-acids on achalasia patients... were

we able to get them to absorb and work properly, could they cause LES

relaxation?

Tasty food for my thoughts, thank you.

-Jess

> I have not verified the accuracy of this information, but it is

interesting. I am going to discuss it with my surgeon Thursday.

>

> " Killing off (stomach) acid, however it's done, is a serious mistake

> with long term consequences if pursued over time. Poor digestion

> is the genesis of all sorts of problems. "

>

> That quote from HSI Panelist Allan Spreen, M.D. appeared in

> the e-Alert " Fire Down Below " (12/23/02). And I immediately

> recalled Dr. Spreen's words when I came across an astonishing

> study last week that demonstrates how several popular heartburn

> medications may sharply increase the risk of pneumonia.

>

> ------------------------------------------------------------

> The tradeoff

> ------------------------------------------------------------

>

> The new study appears in an October issue of the Journal of the

> American Medical Association, and was conducted by researchers

> at a university medical center in the Netherlands. The Dutch team

> evaluated data collected from the medical records of more than

> 360,000 patients enrolled in a primary care database. Each subject

> had been enrolled for a minimum of one year.

>

> The researchers concluded that the use of drugs to suppress gastric

> acid quadrupled the risk of pneumonia compared to patients who

> didn't use the drugs. That's right: Four TIMES the risk!

>

> The drugs analyzed in this study were from two different classes:

> proton pump inhibitors (for acid reflux) and H2 receptor

> antagonists (for heartburn). Here are the familiar brand names in

> these two classes:

>

> Proton pump inhibitors: Nexium, Prilosec, Prevacid, Protonix,

> Aciphex

>

> H2 receptor antagonists: Pepcid, Zantac, Tagamet, Rotane, Axid

>

> And to make matters worse, some patients are not even taking

> these drugs to address heartburn or acid reflux. As one doctor told

> WebMD, many physicians who prescribe nonsteroidal anti-

> inflammatory drugs (NSAIDs) to address arthritis pain, also

> prescribe acid-suppressing drugs to offset the risk of ulcers.

>

> The justification for using these drugs is based on the completely

> wrongheaded belief that stomach acid is bad. Which overlooks the

> obvious: Stomach acid is there for a reason. You can't digest food

> without it! No wonder Dr. Spreen calls acid suppression " a serious

> mistake with long term consequences. "

>

> ------------------------------------------------------------

> Acids rising

> ------------------------------------------------------------

>

> So, how might an acid-suppressing drug increase the risk of

> pneumonia? The Dutch study doesn't answer that question, which

> opens the door to some interesting speculation.

>

> In the WebMD article about the study, Peura, M.D., who is

> a spokesman for the American Gastroenterological Association,

> observed that untreated acid reflux is known to increase the risk of

> pneumonia. Noting that subjects in the study who received the

> highest doses of acid-suppressants had the highest risk of

> pneumonia, Dr. Peura asked this hypothetical question: What

> caused the pneumonia; the acid reflux, or the drug to treat acid

> reflux?

>

> When I asked Dr. Spreen for his insights on this matter, he

> suggested that the drug itself doesn't cause pneumonia, but rather

> sets the stage for stomach acid to create problems. But if the drug

> suppresses acid, how can acid be the cause of the pneumonia risk?

> Dr. Spreen explains:

>

> " When acid is reduced (which makes you feel better for awhile), it

> also loosens the gastroesophageal (GE) sphincter, the 'door' that's

> supposed to close between the stomach and the esophagus when

> digestion is going on (or trying to, anyway). The body is trying to

> insulate the esophagus from the acid. But if there's no longer much

> acid, why waste all that energy and effort?

>

> " So, the sphincter loosens, permitting what little acid remains to

> slip up into the esophagus. This is where the 'heartburn' and

> esophageal damage (Barrett's esophagus) come from, and the

> subsequent need for more 'anti-acid' therapy. See where this is

> headed over the long run?

>

> " If the acid migrates far enough (and I believe it does in these

> cases), it reaches the junction where the lungs branch off, and

> there's the rub. Even the tiniest amount of acid is highly

irritating

> to such membranes, and subsequently a source for trouble to start,

> including infection. "

>

> ------------------------------------------------------------

> Between a rock and a hard place

> ------------------------------------------------------------

>

> It's obvious from the popularity of acid-suppressing drugs that

> there are plenty of people who suffer from occasional heartburn or

> chronic acid reflux. Leaving the production of excess acid

> unchecked is not only painful, but also dangerous. But suppressing

> the acid can create dangerous problems as well, and pneumonia

> risk is just one of them.

>

> In an e-Alert I'll send you next week, I'll review Dr. Spreen's

> simple, inexpensive and effective way to treat gastroesophageal

> problems without suppressing acids.

>

> **************************************************************

[Guest guest]

I agree with what you've said Notan. I was mis-diagnosed w/ GERD as

well. The first antacid she put me on made everything in my esophegus

foam, which only made me more ill. I have a second perscription for a

different kind that I only took for a few days, by that time I was

positive it wasn't GERD but wasn't aware enough of my actual symptoms

to say if there was a difference (at that point I still thought it was

a food allergy). I'm thinking of trying it out as an experiment. My

main thought is, like the other pill, if it doesn't make it to my

stomach, will it still be effective? I'll have to put more thought in

and some research on exactly how that particular medication works.

I figure your probably right, with all of the gerd misdiagnosis, we'd

probably be aware if it had a positive effect.

-Jess